North West LHIN Indigenous Health

Overview

The LHIN’s Role in Indigenous Health

The North West LHIN is committed to improving access to equitable, effective, and culturally sensitive health care for Indigenous people in the Northwest. Over the three years of the LHIN Integrated Health Service Plan 2016-2019, the LHIN will expand existing efforts in several key areas of Indigenous health. Special focus will be given to vulnerable groups such as youth, elders, and socially disadvantaged persons. The following approaches will be advanced through greater collaboration between the Indigenous population, health service providers, and provincial and federal partners:

Continue to build strong relationships with Indigenous people through engagement and inclusion of Indigenous stakeholders and communities

Integrate care where possible between federal, provincial, Indigenous and LHIN programs and services (e.g. home and community care)

Create sustainability through partnerships, coordinated service delivery and integration of funding and accountability agreements.

Central to meeting the needs of the Indigenous population is an understanding of the diversity between and within Indigenous communities related to culture, history, geography, and service delivery. The North West LHIN engages with Indigenous leadership, communities, and health service providers to discuss health system challenges, and use this information to inform North West LHIN planning priorities in strengthening the system of care for people living in Northwestern Ontario.

Challenges and Successes

Indigenous residents living in First Nation communities and urban centres continue to face significant hurdles when accessing health care services. Populations spread across a large geography, language and cultural barriers, historical traumas, challenges in timely access to services, and the need for greater coordination between various funding agencies and levels of government are all factors that contribute to inequitable access and the quality of care that Indigenous individuals receive.

Despite significant challenges, the North West LHIN is committed to promoting close working relationships with Indigenous organizations and communities to improve access to care and health outcomes for Indigenous patients. The following are highlights of recent progresses made across the region:

Provided three-year pilot funding to the Regional Critical Care Response Program which now includes outreach to 4 Indigenous remote nursing stations which now have access to the Regional Critical Care Response service.

Launched Indigenous Inter-professional Primary Care Teams Expansion initiative with the Ministry of Health and Long Term Care, creating 10 new Indigenous-led Primary Care teams in the North West LHIN.

Provided Point of Care testing to seven municipalities and 17 First Nation communities, three programs offer services specifically to the urban Indigenous population.
Advanced Indigenous Cultural Safety training for all LHIN staff and some LHIN funded health service providers in 2017-2018. To date, 349 health care workers have registered for this training. By June 2018, all LHIN staff will have completed the training.

Supported response to social crisis in First Nations communities:

Coordinated a system response with LHIN funded HSPs to assist in providing services to the communities in crisis and, facilitated discussions between multiple system stakeholders on initiatives identified by communities

Provided crisis support to Wapekeka First Nation.

Continued to support Dennis Franklin Cromarty High School to manage drug withdrawal for students and provide wrap-around cultural and recreational services to students attending this high school.

Worked with several community stakeholders to identify priorities for one-time, short term funded initiatives in 2017-18. Successful proposals included a wide-range of initiatives:

Community crisis response

Youth mental health

Community support services

Local community support services worker training and capacity building

Together with Health Canada, Ornge, and First Nations partners, introduced point-of-care lab testing systems (i-STAT) in Sandy Lake and Pikangikum. The system allows for blood testing in First Nations’ nursing stations, thus delivering care closer to home, reducing uncertainty of diagnosis, avoiding unnecessary transfers and gaining associated cost savings. Expansion of i-STAT implementation to all 22 remote fly-in nursing stations across the North West LHIN region is planned for later this year and into 2018.

Additional information on progress achieved across the region can also be found in the following documents:

Aboriginal Health Services Advisory Committee

Collaboration and engagement with many stakeholders is integral to the mission of the North West LHIN. In 2009, the North West LHIN established an Aboriginal Health Services Advisory Committee which is inclusive of Aboriginal people across the LHIN. Committee members bring diverse perspectives and expertise to the Advisory Committee based on experiences and affiliations in their own communities, sectors and organization, with the mandate to provide advice to the North West LHIN regarding:

The health needs and priorities of the Aboriginal people and communities in the Northwest region.

Health service delivery issues affecting the Aboriginal people and communities in the Northwest region.

Following the release of Ontario’s Patients First Act, 2016, and significant LHIN transformation initiatives, the North West LHIN is currently in the process of transitioning the Aboriginal Health Services Advisory Committee to a new Indigenous Health Council. For further information please see the contact information below.

Indigenous Population within the Region

The Indigenous population within the North West LHIN is comprised of Cree, Ojibway, and Oji-Cree identified cultural groups, representing approximately 21.5% of the total population in Northwestern Ontario, the highest regional proportion of Indigenous people across Ontario. Numerous reports, data, and community engagement confirm that the health status of Indigenous people in the Northwest is poorer than non-Indigenous people on most measurable health indicators. Higher rates of medically complex chronic health conditions such as diabetes, hypertension and mental health disorders, early onset of aging, and high rates of suicide and suicide ideation, are all significant regional issues.

Population and Language

69 recognized First Nations

90+ reserves / settlement areas

Three major languages

Four treaty areas

Four Political Territorial Organizations

Nine tribal councils

44,375 Indigenous people live in the North West LHIN Region

Indigenous people make up 21.5% of the total population

About 40% of Indigenous people in the region live in urban centres making up nearly 12% of the people in our cities and towns

Major spoken languages within the region include Ojibway, Oji-Cree and Cree.

Approximately 24.7% of Indigenous people in the region have knowledge of an Indigenous language. Fewer people use their language on a regular basis at home or at work

Rates of language knowledge range from 37.2% in the Kenora Census District, to 13.0% in the Thunder Bay Census District

Geography

25 fly-in communities (in the summer, can only be accessed by air)

23 of these communities have winter road access to the rest of Ontario

Significant health disparities exist for Indigenous people in Ontario and across Canada, and while health care providers want to deliver the highest quality care possible, they often times lack the education to work effectively with Indigenous peoples.

To address this gap, the Ministry of Health and Long-Term Care, and all Local Health Integration Networks are advancing a system wide approach to ensuring Indigenous people have access to culturally appropriate care and improved health outcomes.

The North West LHIN is focused on increasing Indigenous Cultural Safety (ICS) training opportunities for health service providers across the region. In support of this, the North West LHIN funds a limited number of seats for LHIN funded providers to complete online ICS training. All North West LHIN staff and board members also complete ICS training.

If you are a LHIN funded health service provider interested in learning more about ICS training, please contact Larry Spence, Indigenous Health Specialist in the contact: Ontario Indigenous Cultural Safety Program